<%@ page language="java" contentType="text/html; charset=utf-8"
	pageEncoding="utf-8" isELIgnored="false"%>

<%
	request.setAttribute("title","意健险详情");
	request.setAttribute("modelConfigPath", "insu");
%>

<%@ include file="/WEB-INF/views/shared/master/contentHeader.jsp"%>
<style type="text/css">
.content{
	margin-buttom:28px;
}
</style>

<t:panel cssClass="panel-flat form-detailed" customBody="true" customHead="true">
    <div class="detailed-navbar-content panel-body">
        <t:form commandName="fanhuaAccident" action="/admin/insu/fanhuaAccident/save" method="post" cssClass="form-horizontal">
            <div class="hide">
                <t:hidden path="id"/>
                <t:hidden path="deleteMark"/>
                <t:hidden path="customerId"/>	
                <t:hidden path="orderState"/>
            </div>
            <t:formgroup>
                <t:label path="orderId" cssClass="col-sm-2" />
                <t:input path="orderId" colClass="col-sm-4" />
                <t:label path="policyNo" cssClass="col-sm-2" />
                <t:input path="policyNo" colClass="col-sm-4" />
            </t:formgroup>
            
            <t:formgroup> 
                <t:label path="startTime" cssClass="col-sm-2" />
                <t:input path="startTime" colClass="col-sm-4" />
                <t:label path="endTime" cssClass="col-sm-2" />
                <t:input path="endTime" colClass="col-sm-4" />
            </t:formgroup>
            
            <t:formgroup>
                <t:label path="submitTime" cssClass="col-sm-2" />
                <t:input path="submitTime" colClass="col-sm-4" />
                <t:label path="insureComName" cssClass="col-sm-2" />
                <t:input path="insureComName" colClass="col-sm-4" />
            </t:formgroup>
            <t:formgroup>
                <t:label path="productName" cssClass="col-sm-2" />
                <t:input path="productName" colClass="col-sm-4" />
                <t:label path="totalAmount" cssClass="col-sm-2" />
                <t:input path="totalAmount" colClass="col-sm-4" />
            </t:formgroup>
            <t:formgroup>
                <t:label path="orderNum" cssClass="col-sm-2" />
                <t:input path="orderNum" colClass="col-sm-4" />
                <t:label path="insuredIdNo" cssClass="col-sm-2" />
                <t:input path="insuredIdNo" colClass="col-sm-4" />
            </t:formgroup>
            <t:formgroup>
                <t:label path="insuredEmail" cssClass="col-sm-2" />
                <t:input path="insuredEmail" colClass="col-sm-4" />
                <t:label path="insuredBirthday" cssClass="col-sm-2" />
                <t:input path="insuredBirthday" colClass="col-sm-4" />
            </t:formgroup>
            <t:formgroup>
                <t:label path="insuredAppntShip" cssClass="col-sm-2" />
                <t:input path="insuredAppntShip" colClass="col-sm-4" />
                <t:label path="insuredName" cssClass="col-sm-2" />
                <t:input path="insuredName" colClass="col-sm-4" />
            </t:formgroup>
            <t:formgroup>
                <t:label path="insuredMobile" cssClass="col-sm-2" />
                <t:input path="insuredMobile" colClass="col-sm-4" />
                <t:label path="insuredSex" cssClass="col-sm-2" />
                <t:input path="insuredSex" colClass="col-sm-4" />
            </t:formgroup>
            <t:formgroup>
                <t:label path="insuredIdType" cssClass="col-sm-2" />
                <t:input path="insuredIdType" colClass="col-sm-4" />
                <t:label path="appntBirthday" cssClass="col-sm-2" />
                <t:input path="appntBirthday" colClass="col-sm-4" />
            </t:formgroup>
            <t:formgroup>
                <t:label path="appntIdType" cssClass="col-sm-2" />
                <t:input path="appntIdType" colClass="col-sm-4" />
                <t:label path="appntIdNo" cssClass="col-sm-2" />
                <t:input path="appntIdNo" colClass="col-sm-4" />
            </t:formgroup>
            <t:formgroup>
                <t:label path="appntMobile" cssClass="col-sm-2" />
                <t:input path="appntMobile" colClass="col-sm-4" />
                <t:label path="appntName" cssClass="col-sm-2" />
                <t:input path="appntName" colClass="col-sm-4" />
            </t:formgroup>
            <t:formgroup>
                <t:label path="appntEmail" cssClass="col-sm-2" />
                <t:input path="appntEmail" colClass="col-sm-4" />
                <t:label path="noticeCode" cssClass="col-sm-2" />
                <t:input path="noticeCode" colClass="col-sm-4" />
            </t:formgroup>
            <t:formgroup>
                <t:label path="appStatus" cssClass="col-sm-2" />
                <t:input path="appStatus" colClass="col-sm-4" /> 
                <t:label path="downloadURL" cssClass="col-sm-6" />
                <t:input path="downloadURL" colClass="col-sm-6" />
            </t:formgroup>
        </t:form>
    </div>
</t:panel>

<script type="text/javascript">
	function saveData() {
		if (!$("form:first").valid()) {
			return;
		}
		$("form:first").submit();
	}
</script>
<%@ include file="/WEB-INF/views/shared/base/scripts/jqueryui.jsp"%>
<%@ include file="/WEB-INF/views/shared/base/scripts/limitless/default/formselects.jsp"%>
<%@ include file="/WEB-INF/views/shared/base/scripts/limitless/default/formstyling.jsp"%>
<%@ include file="/WEB-INF/views/shared/base/scripts/limitless/default/formpickers.jsp"%>
<%@ include file="/WEB-INF/views/shared/master/dialog.jsp"%>
<%@ include file="/WEB-INF/views/shared/scripts/editor/ueditor.jsp"%>
<%@ include file="/WEB-INF/views/shared/base/scripts/tools/upload-cos.jsp"%>
<%@ include file="/WEB-INF/views/shared/master/contentFooter.jsp"%>
